Noninvasive Diagnosis of Hepatocellular Carcinoma on Sonazoid-Enhanced US: Value of the Kupffer Phase

Diagnostics

Kentaro Sakamaki¹  Takuya Wada²  Tatsuya Kakegawa²  Yusuke Tomita²  Katsutoshi Sugimoto²  Hiroshi Takahashi²  Takao Itoi²  Masakazu Abe²  Yu Yoshimasu²  Hirohito Takeuchi²  Naohisa Kamiyama³ 

[1] Center for Data Science, Yokohama City University, Yokohama 236-0027, Japan;Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo 160-0023, Japan;Ultrasound General Imaging, GE Healthcare, Hino-shi 191-0065, Japan;

关键词: ultrasound;    contrast media;    Sonazoid;    hepatocellular carcinoma;    CEUS;    LI-RADS;   

DOI  :  10.3390/diagnostics12010141

来源: DOAJ

【 摘 要 】

The aim of this study was to compare the diagnostic performance of Contrast-Enhanced US Liver Imaging Reporting and Data System (CEUS LI-RADS) version 2017, which includes portal- and late-phase washout as a major imaging feature, with that of modified CEUS LI-RADS, which includes Kupffer-phase findings as a major imaging feature. Participants at risk of hepatocellular carcinoma (HCC) with treatment-naïve hepatic lesions (≥1 cm) were recruited and underwent Sonazoid-enhanced US. Arterial phase hyperenhancement (APHE), washout time, and echogenicity in the Kupffer phase were evaluated using both criteria. The diagnostic performance of both criteria was analyzed using the McNemar test. The evaluation was performed on 102 participants with 102 lesions (HCCs (n = 52), non-HCC malignancies (n = 36), and benign (n = 14)). Among 52 HCCs, non-rim APHE was observed in 92.3% (48 of 52). By 5 min, 73.1% (38 of 52) of HCCs showed mild washout, while by 10 min or in the Kupffer phase, 90.4% (47 of 52) of HCCs showed hypoenhancement. The sensitivity (67.3%; 35 of 52; 95% CI: 52.9%, 79.7%) of modified CEUS LI-RADS criteria was higher than that of CEUS LI-RADS criteria (51.9%; 27 of 52; 95% CI: 37.6%, 66.0%) (p = 0.0047). In conclusion, non-rim APHE with hypoenhancement in the Kupffer phase on Sonazoid-enhanced US is a feasible criterion for diagnosing HCC.

【 授权许可】

Unknown